摘要
目的探讨不同地区政策支持性环境对社区卫生服务中心医务人员提供签约服务态度的影响。方法采用多阶段分层整群抽样方法,选取四川省成都市双流区、成华区和福建省厦门市集美区、海沧区各1家社区卫生服务中心的192名(成都99名,厦门93名)工作人员进行问卷调查;同时收集抽样地区签约服务的相关政策文献进行梳理和比较,探讨成都和厦门地区家庭医生签约服务的政策环境对工作人员签约服务态度的影响。应用EpiData软件建立数据库并录入数据,应用SAS9.4软件进行统计分析。结果成都和厦门签约服务政策在任务目标、筹资模式和医保政策等方面存在较大差异。在调查的192名社区卫生服务工作人员中,80.7%在综合利弊后认为开展签约服务值得,90.8%支持或部分支持签约服务工作,78.1%愿意承担更多的签约服务工作,然而仅有41.6%愿意自己子女从事家庭医生工作。对于签约服务持消极态度的主要原因为签约服务绩效未及时落实及工作量的增加。结论成都市和厦门市社区卫生服务机构工作人员普遍认可签约服务,但态度差异较大;政策和经费支持、人力资源的合理配置是影响签约服务态度的关键因素。
To explore the influence of policy support on attitude of staff toward contracted service in community health service (CHS) centers in different areas of China.Methods A multi-stage stratified cluster sampling method was used to select participants,and questionnaire survey was conducted among 192 staff (99 from Chengdu and 93 from Xiamen) from 4 community health service centers in Chengdu and Xiamen.In addition,documents on contracted service in CHS were collected and analyzed.EpiData software was used to establish database.Double input and cross-check were implemented.SAS version 9.4 was used for data analyses.Results Differences were found in goals,financial modes and insurances coverage in contracted service in the two areas.Among the 192 participants,80.7% considered that contracted service was worth to carry out;90.8% supported the implementation of contracted service in local settings and 78.1% were willing to take more work load on contracted service.In contrary,only 41.6% wished their child work as a family doctor.The main reasons for the negative attitudes were that the performance-based salary system had not been well established or implemented,and there was much more work load that resulted from contracted service.Conclusions The majority of the study subjects held positive attitude toward contracted service,but there were disparities between the four study sites.Relative policy and financial support,proper human resource distribution were critical determinants of contracted service.
作者
殷涛
关梦然
尹德卢
鄂啟顺
何慧婧
陈博文
Yin Tao;Guan Mengran;Yin Delu;Ao Qishun;He Huijing;Chen Bowen(Capital Institute of Pediatrics,Chinese Community Health Association,Beijing 100020,China;Beijing Community Health Services Management Centre,Beijing 100053,China;Family Physicians′ Office,Primary Health Care Department,National Health Commission,Beijing 100044,China;Department of Epidemiology and Statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences & School of Basic Medicine,Peking Union Medical College,Beijing 100005,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2019年第5期402-406,共5页
Chinese Journal of Hospital Administration
基金
北京市自然科学基金(9174034)
国家卫生计生委项目(2017).
关键词
医师
家庭
签约服务
意愿
态度
问卷调查
Physicians, family
Contracted service
Willingness
Attitude
Questionnaire survey
